Feds OK Arizona plan to expand KidsCare eligibility, pay parent caregivers

Arizona officials said Tuesday they have been given federal approval to
expand income eligibility for the state’s KidsCare program, a change
that could add 10,000 children to the low-cost health care program run
by the state.

They also said they got the green light to make permanent what
started as a pandemic-era program to compensate parents who act as
caregivers for their disabled children.

“When kids have access to affordable health care, it means more than
just a healthier life,” Gov. Katie Hobbs said as she announced the
changes Tuesday.

“It means better high school and college graduation rates. It means
they’re more likely to find a good paying job, and it means they can
grow up to reach their full potential without having to rely on Medicaid
as an adult,” Hobbs said.

The changes
would raise the income eligibility limit for the state’s Children’s
Health Insurance Program – also called KidsCare – from the current 200%
of the federal poverty level to 225%. That means a family of four
earning up to $70,200 would be eligible to enroll their children,
expanding eligibility to an additional 10,000 children in Arizona.

Hobbs’ office said the Legislature last year approved $5.5 million for KidsCare
expansion in fiscal 2024 and $6.6 million in fiscal 2025 for the
KidsCare expansion. But the change required approval from the federal
government, which pays more than three-quarters of the program’s cost.

The state applied in November and the Center for Medicare and Medicaid Services gave its OK Friday. Arizona families can begin applying under the new rules on March 1, for coverage to start in April.

Also Friday, CMS
approved the state’s request to make the Parents as Paid Caregivers
program permanent. That program, which pays parents who provide direct
care services to their children with disabilities, was originally
designed to assist parents during the COVID-19 pandemic when it was hard
to get outside care.

CMS granted a temporary extension of the program
in October, before giving permanent approval last week. A Hobbs’
spokesperson said the state also allocated $133,100 last year in
anticipation of making the program permanent.

“Reimbursing parents as paid caregivers is a step in the right
direction and the right thing to do for children who need these critical
services from those they feel the most comfortable with – their
parents,” said Carmen Heredia, Cabinet Executive Officer for the Arizona
Health Care Cost Containment System, the state’s Medicaid program.

The program is essential for Brandi Coon, whose 9-year-old son Tyson
was diagnosed with cerebral palsy, epilepsy and traumatic brain injury
after contracting bacterial meningitis as a baby.

“As Tyson’s mom, I am both his parent and his caregiver,” Coon said
at Tuesday’s news conference. “Those roles interweave constantly.”

Coon said an average day of caring for Tyson entails caring for his
physical needs, including preparing medications, food and water for his
feeding tube. She takes him to a microschool, where he “loves to do hard
things with age-appropriate learning curriculum, with modifications to
help him succeed academically and socially.”

Coon co-founded the Raising Voices
Coalition in 2021 to advocate for family caregivers and push for the
program to become permanent. She said after a failed online petition,
the group began “meeting with experienced advocates, disability
organizations, and state leaders.”

“After hearing that a permanent program was not a feasible option –
many times – we persevered in growing our grassroots advocacy community
of parent caregivers, gathering data and building relationships with
elected officials in order to have our voices heard,” she said.

After AHCCCS applied with CMS to make the program permanent, Coon
said the coalition “submitted hundreds of public comments where we
shared with AHCCCS our personal experiences, recommendations, and
feedback regarding their proposal.” That pushed AHCCCS to amend the
proposal and expand the scope of disabilities that would be covered by
the program.

The KidsCare program is a low-cost health care program run by the
state, that offers care to families that earn too much to be eligible
for Medicaid. Families in the program pay a premium for health care, but
it is limited to $50 a month for one child and $70 a month for two or

Hobbs Tuesday referenced the fact that Arizona cut its CHIP program during the Great Recession, before restoring it in 2016.

“For years Arizona was the only state in the country without a
Children’s Health Insurance Program,” Hobbs said. “Thankfully,
bipartisanship prevailed.”

But the CHIP program was still anemic when Hobbs was elected. Arizona
ranked 49th among 50 states and the District of Columbia for its share
of uninsured children in 2022, according to a Georgetown University report.
It said 8.4% of children in the state did not have health insurance
that year, with communities of color significantly outweighing whites in
rates of uninsured children.

“As Arizona continues to grow, this is a smart investment that will protect our collective futures,” Hobbs said Tuesday.